Tissue preservation system

ABSTRACT

The present invention provides a method and apparatus for tissue, such as an allograft, storage and preservation for extended periods of time at room temperature in a sterile tissue culture chamber. The invention further provides a process for maintaining the sterility of tissue using the apparatus as described.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.16/562,145, filed Sep. 5, 2019 (pending) which application is acontinuation of U.S. application Ser. No. 16/022,452, filed Jun. 28,2018 (issued U.S. Pat. No. 10,881,098) which application is acontinuation of U.S. application Ser. No. 14/946,634, filed Nov. 19,2015 (issued U.S. Pat. No. 10,039,277) which application is a divisionalof U.S. application Ser. No. 13/349,534, filed Jan. 12, 2012 (issuedU.S. Pat. No. 9,220,258), which claims the priority of U.S. ProvisionalApplication No. 61/461,049, filed on Jan. 12, 2011, the entiredisclosures of which are incorporated herein by reference.

FIELD OF THE INVENTION

The invention relates to the field of tissue, such as an allograft,storage and more specifically to the field of long-term tissue storageand preservation.

BACKGROUND OF THE INVENTION

Allograft or other tissue samples are used to treat many diseases and/ordefects. These grafts are procured from organ donors and must be storedto allow for viral and bacterial testing for safety prior to shipping tosurgical centers for implantation into patients. Based on studieslooking at viability of the cells in the grafts, recommendations havebeen given for implanting tissues as soon after harvest as possible inorder to maximize success. Safety testing takes a minimum of 7 days andmore often 10-14 days for final clearance. Storage of tissue, such asallograft tissue, for transplantation or other scientific or medicalpurposes allows time for medical testing, recipient patient preparation,or to preserve tissues for other purposes. Storage conditions forallograft or other tissue samples may influence tissue viability,integrity, and/or sterility.

SUMMARY OF THE INVENTION

Briefly described, embodiments of this disclosure provide a process andapparatus for tissue preservation. In one aspect, the invention providesa process for tissue preservation by storing the tissue at roomtemperature in a container with culture media for from about 7 to about70 days before implantation into a patient. In one embodiment, thetissue is tested for viability at least once prior to implantation in apatient. In another embodiment, viability testing is performed byassaying media that is withdrawn from the container. In anotherembodiment, cell viability is determined by adding a resazurin solutionto the media and determining the fluorescence level, wherein increasedfluorescence indicates higher cell viability.

In another embodiment, the tissue is stored in the container for from 29to about 70 days. In other embodiments, the media is changed at leastonce or about once every two weeks during storage. In anotherembodiment, at least about 70% of tissue preserved by this methodremains viable after 45 days of storage.

One aspect of the invention provides media used for storage of tissuethat is serum-free and can contain Dulbecco's Modified Eagle Medium(DMEM), high or low concentrations of glucose, antibiotic compounds(i.e., penicillin and/or streptomycin), antimycotic compounds (i.e.,Fungizone), dexamethasone, ascorbate 2-phosphate, L-proline, sodiumpyruvate, TGF-β3, and insulin, transferrin, and selenous acid, amongother chemicals or compounds.

In another aspect of the invention, the media is serum-free. In anembodiment, the media contains an effective amount of dexamethasone. Inanother embodiment, the tissue is a section of spine, scapula, humerus,radius, ulna, pelvis, femur, tibia, patella, talus, phalanges ortemporomandibular joint tissue. Other embodiments of this inventionprovide lavage of the tissue in an isotonic solution prior to storing,and implanting the tissue into a patient after storage.

Another aspect of the present invention provides a process for storageof tissue in a tissue preservation chamber containing a base, lid, mediainlet, and media outlet, wherein the media inlet is coupled to at leasta first filter for maintaining a sterile environment inside the chamber,the base is configured to contain tissue and media, the outlet extendinginto the chamber permits removal of media, a one-way valve as the mediaoutlet for removing media from the chamber, and wherein the base iscapable of receiving the lid to form a barrier to contaminants. Inembodiments of this invention, a gas exchange port is coupled to atleast a first filter, and the lid contains the media inlet, mediaoutlet, and gas exchange port. In another embodiments, the tissue isstored in the chamber for from about 29 days to about 60 days.

Another aspect of the present disclosure provides a tissue preservationchamber, including a base, lid, media inlet, and media outlet, whereinthe media inlet is coupled to at least a first filter for maintaining asterile environment inside the chamber, the base is configured tocontain cartilage tissue and media, the outlet extends into the chamberto permit removal of media, the media outlet is a one-way valve for exitof media from the chamber, and the base is capable of receiving the lidto form a barrier to contaminants. In other embodiments, a gas exchangeport is coupled to at least a first filter, the lid contains the mediainlet, media outlet and gas exchange port, and the lid is a filter thanextends across the media inlet and gas exchange port. In one embodiment,the filter is a basket adapted to be received by the lid to form arecess for sterile filter paper, the recess being in fluid and gascommunication with the media inlet and gas exchange port. In anotherembodiment, the media inlet and gas exchange port are coupled todifferent filters for maintaining a sterile environment within thechamber. In another embodiment, the media inlet and gas exchange portare coupled to the same filter to maintain a sterile environment withinthe chamber. In other embodiments, the media inlet and outlet serve asadaptors for receiving a hose. In another embodiment, the base and lidare configured to form a rim for sealing with tamper-evident tape whenin contact.

One exemplary method of tissue storage at room temperature in a chamberwith culture media before implantation includes: placing the tissue in achamber base, the chamber base configured to maintain the tissue andtissue preservation media, and forming a tissue preservation chamber bycovering the chamber base with a lid to form a barrier to contaminants,and wherein the lid contains at least one filter, a media inlet coupledto at least one filter for maintaining a sterile environment inside thechamber, and a media outlet, the media outlet including a media outletconduit that extends into the chamber to permit removal of media andreentry of media exiting the chamber. In an embodiment, the chamber alsohas a gas exchange port coupled to at least one filter. In anotherembodiment, the lid comprises the media inlet, media outlet, and gasexchange port.

An aspect of the present invention provides addition of media to thechamber through the media inlet and at least one filter. One embodimentprovides storage of the tissue in the chamber for from 29 days to about70 days. Other embodiments provide removal of the media from the chamberthrough the media outlet. A further embodiment provides simultaneousaddition of media to the chamber by forcing through the media inlet andat least one filter, along with removal of media from the chamberthrough the media outlet. Another embodiment of the present inventionprovides applying tamper evident tape to an interface between thechamber base and the lid in order to maintain sterility of the tissue.

The foregoing and other aspects of the invention will become moreapparent from the following detailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a perspective view of a tissue preservation chamberaccording to an illustrative embodiment.

FIG. 2A shows an exploded perspective view illustrating the uppersurfaces of the components of the tissue preservation chamber of FIG. 1.

FIG. 2B shows an exploded perspective view illustrating the lowersurfaces of the components of the tissue preservation chamber of FIG. 1.

FIG. 3 shows a side, cross-section view of a base of an illustrativeembodiment of a tissue preservation chamber, including a piece oftissue.

FIG. 4 shows a side, cross-section view of an illustrative embodiment ofa tissue preservation chamber, including the base of FIG. 3 and a lid.

FIG. 5 shows a side, cross-section view of an illustrative embodiment ofa tissue preservation chamber, including the flow of media into thetissue preservation chamber.

FIG. 6 shows a side view in partial cross-section of an illustrativeembodiment of a tissue preservation chamber being used to store andpreserve tissue.

FIG. 7 shows a side view in partial cross-section of an illustrativeembodiment of a tissue preservation chamber, including the flow of gasinto and out of the chamber.

FIG. 8 shows a side view in partial cross-section of an illustrativeembodiment of a tissue preservation chamber, including the flow of gasinto and out of the tissue preservation chamber and the flow of mediaout of the tissue preservation chamber.

FIG. 9 shows a side, cross-section view of an illustrative embodiment ofa tissue preservation chamber, including the flow of media into thechamber, the flow of gas into and out of the chamber, and the flow ofmedia out of the tissue preservation chamber.

FIG. 10 shows tissue viability at days 1, 28, and 56.

FIG. 11 shows tissue proteoglycan content at days 0, 28, and 56.

FIG. 12 shows tissue proteoglycan (μg GAG/mg tissue dry weight) andCollagen (μg HP/mg tissue dry weight) content at day 0 and days 63-75for each OCA storage group.

FIG. 13 shows scatter plots for each media protein biomarker (pg/ml) andthe media viability additive (fluorescence level) compared to tissueviability (LC/μm2) at the end of storage (day 63-75).

DETAILED DESCRIPTION

The following definitions and methods are provided to better define thepresent invention and to guide those of ordinary skill in the art in thepractice of the present invention. Unless otherwise noted, terms are tobe understood according to conventional usage by those of ordinary skillin the relevant art.

The present disclosure provides a process and apparatus for tissuepreservation. The process includes, in one embodiment, removing viabletissue, such as allograft tissue, from a donor, testing of the tissuefor infectious diseases and/or mechanical and/or biochemical activityfor viability, placement of the viable tissue into a sterile tissueculture preservation chamber as described herein with a culture mediumcapable of maintaining the viability and sterility of the tissue, andstoring the tissue for extended periods of time prior to implantationinto a recipient. As used herein, the term “allograft” refers to atissue graft from a donor of the same species as the recipient but notgenetically identical. In an embodiment, at least about 90% of tissue orallografts preserved by the process described herein remain viable after45 days of storage. In another embodiment, the tissue is lavaged inisotonic solution prior to storing. In still another embodiment, thetissue is allograft tissue.

Allograft tissue can be removed from a donor by techniques known in theart. For instance, general aseptic surgical methods or other physicalintervention of an allograft may include but are not limited toexcision, resection, amputation, transplantation, microsurgery, generalsurgery, laser surgery, robotic surgery, or autopsy, among others.

Tissue or allograft sources may be cells, tissues, or organs from alltypes of organisms, including, but not limited to human, porcine, ovine,bovine, canine, equine, and others. In one embodiment, the source of thetissue or allograft is human. Potential allograft sources may include,but are not limited to, tissues of the eye, brain, heart, kidney, liver,intestine, bone, cartilage, skin, lung, thyroid, stomach, ligaments,tendons, or any other tissue and/or cell source that may requiretransplantation. In one embodiment of the invention, the allograft maycomprise bone and/or cartilage and/or meniscus tissue of the spine,scapula, humerus, radius, ulna, pelvis, femur, tibia, fibula, patella,talus, phalanges, or temporomandibular joint. In another embodiment, theallograft may be osteochondral tissue. Although the description hereinmay refer to allograft tissue, one of skill in the art appreciates thatother tissues find use in the method.

Once removed from the donor, the allograft is stored within the steriletissue culture chamber including, but not limited to, the chamberdescribed herein, for an extended period of time. In one embodiment, theallograft is stored at room temperature in culture media. In specificembodiments, the room temperature is between about 19° C. and 27° C.,including about 19° C., 20° C., 21° C., 22° C., 23° C., 24° C., 25° C.,26° C., or about 26° C. In another embodiment, the allograft is storedat a temperature that is not less than about 12° C. and not more thanabout 30° C.

As used herein, the term “culture media” refers to liquid, semi-solid,or solid media used to support tissue growth and/or preservation and/ordevelopment in a non-native environment. Further, by culture media ismeant a sterile solution that is capable of stabilizing and preservingthe tissue in order to maintain its biological activity and sterility.Suitable tissue culture media are known to one of skill in the art, asdiscussed in detail subsequently. The media components can be obtainedfrom suppliers other than those identified herein and can be optimizedfor use by those of skill in the art according to their requirements.Culture media components are well known to one of skill in the art andconcentrations and/or components may be altered as desired or needed. Inone embodiment, culture media may contain Dulbecco's Modified EagleMedium (DMEM), glucose, antibiotic compounds, antimycotic compounds,dexamethasome, ascorbate 2-phosphate, L-proline, sodium pyruvate,TGF-β3, insulin, transferrin, and selenous acid, among other chemicalsor compounds. In particular, antibiotic compounds may include, but arenot limited to penicillin, streptomycin, chloramphenicol, gentamycin,and the like. Antimycotic compounds may include, but are not limited toFungizone. In an embodiment, the culture media lacks serum. Themedia-to-tissue ratio within the sterile tissue culture chamber may be10-50:1 per volume.

An unexpected benefit of the present procedure is that tissue samplescan be maintained viable and sterile for an extended period of timerelative to methods of the prior art. For instance, typically in theprior art, upon removal of an allograft from a donor, the tissue wasstored on ice or at around 4° C. Tissues prepared according to thismethod tended to remain suitably viable for around 21-28 days. However,the procedure described herein provides for a surprising and unexpectedincrease in viability of allograft tissue. Tissues prepared and storedaccording to the procedure described herein remain viable for anextended period of time relative to storage at 4° C. By an extendedperiod is meant at least between about 7-100 days, at least betweenabout 20-80 days, or at least between about 29-70, 40-70, 50-70 or 60-70days. In one embodiment an extended period is meant up to at leastaround 70 days.

It has been found that long-term storage of tissue may be facilitated byreplacement of old culture medium with fresh, sterile medium. However,prior to the present disclosure, a system that allowed for mediaexchange in an otherwise non-sterile environment was not available. Thepresent disclosure provides a system and device that allows for justthis. Advantageously, the present procedures and device provide forsterile media exchange in an otherwise non-sterile environment. Thus,media can be conveniently changed as necessary. In one embodiment, themedia is changed at least once, twice, or three times during storage.The media may be changed without removing a lid from the storagecontainer, or otherwise opening the container. The media may be changed,in specific embodiments, about once every other day, at least once aweek, at least once every two weeks, or at least about once a monthduring storage. In one embodiment, media is aspirated from the sterilechamber through a media outlet, and replaced by adding fresh mediathrough a media inlet, as described in more detail below with regard toFIG. 9 . In one embodiment, a filter is placed between the lid and basechamber and media flows through the filter into the chamber. Therefore,the media remains sterile. In addition, the filter enables exchange ofCO₂ and O₂ between the chamber and the surrounding air while maintainingsterility inside the chamber.

Prior to storage according to the present disclosure, testing ofallograft tissue encompassed up to or greater than 7 days and requireddirect contact with the allograft. Such methods increased the likelihoodof allograft contamination. The present disclosure provides a convenientand easy method of testing for viability and/or contamination, by simplyextracting the culture medium from the culture chamber through the mediaoutlet, which does not compromise sterility of the tissue. The extendedstorage period allows for examination or testing of the allograft and/orculture media for a number of factors, such as viability, blood typecompatibility, HLA typing, genotyping, SNP detection, and/or infectionwith diseases. Compounds that may be detected or tested may be obtainedfrom culture media withdrawn from the sterile tested such as, but notlimited to, bacterial or virus infections, nitric oxide, prostaglandinE₂, matrix metalloproteinase (MMP)-2, MMP-3, MMP-9, and MMP-13, vascularendothelial growth factor (VEGF), interleukin (IL)-2, IL-4, IL-6, IL-7,IL-8, IL-10, IL-15, and IL-18, granulocyte macrophage colony-stimulatingfactor (GM-CSF), Interferon gamma-induced protein (IP)-10, IFNγ,keratinocyte chemoattractant (KC), MCP-1, and TNFα. Tissue may be testedusing methods known in the art, such as by diagnostic PCR or withantibodies against biomarkers such as, but not limited to, thosedescribed above. The viability of the OCA may also be monitored duringstorage by adding a resazurin solution to the media at a finalconcentration of about 10 μg/ml and incubated at room temperature for18-24 hours. During the incubation, resazurin is converted to resorufinby viable cells in the OCA. A 200-μl sample of the media is taken andthe fluorescence level is determined using a fluorescence reader(540-570 nm excitation, 580-610 nm emission). Increased fluorescence isindicative of higher cell viability. Higher viability samples typicallyhave a fluorescence reading of ˜800-1200 units using a Synergy HT set ata sensitivity of 25 on the reader.

In view of the above, the process provides for preservation of at least70% of the allograft tissue chondrocytes after storage at roomtemperature for 45 days. In an embodiment, at least 60% or 70%, up to atleast around 99%, including 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95% orgreater of the tissue is preserved when stored for 45 days, 60 days, or70 days.

In one embodiment, the process includes storing the tissue in a tissuepreservation chamber. In another embodiment, the process furtherincludes implanting the tissue in a subject in need thereof followingsaid storing.

An illustrative embodiment of a tissue preservation chamber 100 is shownin FIGS. 1, 2A, and 2B. The tissue preservation chamber 100 includes abase 102 that may be formed from any suitable material for storingtissue, e.g., an allograft. The tissue preservation chamber 100 alsoincludes a lid 106 that forms a sealed enclosure when applied to thebase. To form the sealed enclosure, the base 102 may have a firstsealing surface 140 and the lid 106 may include second sealing surface142 that abut one another when the lid 106 is applied to the base 102.In the illustrative embodiment of FIG. 1 , the lid 106 is sized andconfigured to be installed to the base 102 such that the first sealingsurface 140 and second sealing surface 142 are adjacent and coplanarabout the periphery of the tissue preservation canister 100. In such anembodiment, a sterile environment may be ensured by applying a tapeabout the common surface formed at the interface of the lid 106 and base102. In an embodiment, the lid 106 may be formed with a mating feature,such as a lip on the underside of the lid 106 that forms an interferencefit with the interior surface of the base 102. In the illustrativeembodiment of FIG. 1 , the lid 106 and base 102 have a rectangularshape, though it is noted that the tissue preservation chamber may be ofany suitable size and shape.

In an illustrative embodiment, the lid 106 includes features tofacilitate the controlled ingress and egress of gas and liquids to andfrom the tissue preservation chamber 100. These features include a mediaoutlet 110, media inlet 114, and gas exchange port 112. In anembodiment, the lid 106 also includes a filter basket mount 146 that maybe used to attach a filter basket 104. The filter basket mount 146 ofFIG. 2B is a molded portion of the lid 106 that includes an externalsurface 148 that mates with a complimentary internal surface 150 of thefilter basket 104. In an embodiment, the complimentary surfaces 148, 150are tapered surfaces. The filter basket 104 and base 102 may alsoinclude complementary geometrical features to locate the filter basket104 to securely hold a filter within the assembled tissue preservationchamber 100. In such an embodiment, the filter basket 104 may be mountedto the base 102 rather than the lid 106. In some embodiments, anadhesive may be used to hold the filter basket in place. As shown inFIG. 2B, the filter basket 104 includes a grated surface to support afilter without obstructing fluid flow between the tissue preservationchamber 100 and the media inlet 114 or gas exchange port 112. The filterbasket 104 of FIG. 2B is shown as having a single grated surface tosupport a single filter. Yet in some embodiments, the tissuepreservation chamber 100 may include a filter basket 104 capable ofholding multiple filters, or multiple filter baskets to facilitate theuse of separate filters for filtering flow through the media inlet 114and gas exchange port 114.

The top surface of the lid 106 includes protrusions that form the mediainlet 114, the gas exchange port 112, and media outlet 110. The mediainlet 114 may also form a similar protrusion that extends from the innersurface of the lid 106, and is located inside of the filter basket mount146 so that fluid entering the tissue preservation chamber 100 via themedia inlet 112 is routed through the filter basket 104. The gasexchange port 112 may also form a similar protrusion that extends fromthe inner surface of the lid 106, and is located inside of the filterbasket mount 146 so that fluid entering the tissue preservation chamber100 via the gas exchange port 112 is forced through the filter basket104. The protrusions that form the media inlet 114, gas exchange port112, and media outlet 110 shown in FIGS. 2A and 2B comprise taperedannular members that are suitable for coupling to, e.g., a tubingadapter. Nonetheless, the media inlet 114, gas exchange port 112, andmedia outlet 110 may have any suitable size and shape to facilitatefluid flow to and from the tissue preservation chamber 100. For example,in an embodiment, the portions of the lid 106 that protrude from the topsurface of the lid 106 to form the media inlet 114 and media outlet 110include a tapered surface to facilitate coupling to tubing adapters 118and 116, respectively. Similarly, in an illustrative embodiment, themedia outlet 110 is fluidly coupled to a media outlet conduit 108 thatextends into the tissue preservation chamber 100 to facilitate theremoval of fluid from the base of the media outlet conduit 108.

The tissue preservation chamber 100 illustrated in the Figures isoperable to store living tissue. In the illustrative embodiments, themedia outlet 110 and media inlet 114 facilitate the addition and removalof liquid, e.g., tissue culture media, to and from the tissuepreservation chamber 100 while preserving a sealed, sterile environmentwithin the tissue preservation chamber 100. Thus, once made, the tissuepreservation chamber 100 described above finds use in a method ofallograft preservation in which a tissue sample or allograft is storedin the tissue preservation chamber. Such a method is described belowwith regard to FIGS. 3-9 .

In FIG. 3 , tissue 138, such as an allograft, is stored in the base 102of the tissue preservation chamber 100, which is enclosed to form asealed, sterile environment. After adding the tissue 138, the lid 102and filter basket 104 may be installed to enclose the tissuepreservation chamber 100. For example, a filter 120, such as filterpaper, may be placed in the filter basket 104 that is attached to thebase 102 or filter basket mount 146 as described above. The lid 106comprises the media outlet 110, media inlet 114, and gas exchange port112. The media outlet 110 is coupled to the media outlet conduit 108,the base of which includes a media intake aperture 126 to facilitate theremoval of media from the tissue preservation chamber. To help maintainthe sterile environment within the tissue preservation chamber 100, aone-way valve 124 is affixed to the media outlet 110 to prevent theunwanted reentry of removed liquids into the tissue preservation chamber100. The gas exchange port 112 comprises an open conduit 122 that iscoupled to the filter 120, which separates the sterile environment ofthe tissue preservation chamber 100 from the external environment. Themedia inlet 114 forms a conduit through which tissue preservation mediamay be added to the tissue preservation chamber 100 after passingthrough the filter 120.

FIG. 5 shows that liquid 128, such as tissue preservation media, may beadded to the tissue preservation chamber 100 to submerge the tissue 138in the liquid 128. The liquid 128 may be added to the tissuepreservation chamber 100 through the media inlet 114 along a fluid flowpath indicated by the arrows 130. To maintain the sterile environmentwithin the tissue preservation chamber 100, the liquid 128 is forcedinto the tissue preservation chamber 100 through the filter 120.

Sealing tape 156, which may be tamper evident tape, may be applied tothe junction of the lid 106 and base 102 about the periphery of thetissue preservation chamber 100, as shown in FIG. 6 . The addition ofsealing tape 156 helps to ensure the maintenance of a sterileenvironment within the tissue preservation chamber 100. The tape mayalso evidence whether the seal has been compromised. As shown in FIG. 7, tissue 138 may be stored in the tissue preservation chamber for theperiods described above. During storage, air may flow into and out ofthe chamber through the gas exchange port 112 and filter 120, asindicated by the two-way arrows 132.

The liquid 128, e.g., tissue preservation media, may be evacuated fromthe tissue preservation chamber 100 via the media outlet, as indicatedby the arrows 136 of FIG. 8 . Further, constant pressure may bemaintained within the tissue preservation chamber 100 during theevacuation of fluid 128 by allowing filtered air to enter the chambervia the gas exchange port 112 as the fluid 128 is evacuated. Fluidevacuated from the tissue preservation chamber 100 is prevented fromreentering the chamber by one-way valve 124 and is removed from thesystem as indicated by arrows 134.

As shown in FIG. 9 , the liquid 128 may be cycled through the tissuepreservation chamber 100 by adding liquid to the chamber through themedia inlet 114 and filter 120. Simultaneously or at another time,liquid may be removed from the tissue preservation chamber 100 via themedia outlet 110, as indicated by the arrows 134.

EXAMPLES Example 1

Analysis and Comparison of Osteochondral Allograft Metabolism UsingVarious Preservation Protocols

Tissue Harvest and Culture: Medial and lateral femoral condyles (FC)from both knees of 10 adult canine cadavers were aseptically harvestedwithin 4 hours of euthanasia performed for reasons unrelated to thisstudy. The volume of each FC was determined and the FCs (n=40) wereprocessed under aseptic conditions and preserved in Media 1 (M-1) (DMEM,1× ITS (insulin, transferrin, and selenous acid), non-essential aminoacids (1 mM), sodium pyruvate (10 mM), and L-ascorbic acid (50 μg/ml))or Media 2 (M-2) (DMEM, 1× ITS (insulin, transferrin, and selenousacid), non-essential amino acids (1 mM), sodium pyruvate (10 mM),L-ascorbic acid (50 μg/ml), dexamethasone (10 μM), TGF-β3 (2.5 ng/ml),and sodium borate (250 μg/ml)) at 4° C. or 37° C. for 28 or 56 days. Thevolume of media used for preservation was determined by multiplying theapproximate volume of the tissue by 25-30. The media were changed every7 days, and samples saved for subsequent analyses. In a second study,FCs were aseptically harvested from one knee of 5 adult canine cadaverseuthanatized for reasons unrelated to this study. One FC per animal wasprocessed under aseptic conditions and preserved in Media 3 (M-3) (DMEM,1× ITS (insulin, transferrin, and selenous acid), L-glutamine (20 mM),non-essential amino acids (1 mM), sodium pyruvate (10 mM), L-ascorbicacid (50 μg/ml), penicillin, streptomycin, amphotericin B, and sodiumborate (250 μg/ml)) at 37° C. for 56 days as described above. At eachtime point, full-thickness cartilage was evaluated for tissue viability.Media Analysis: Media were analyzed for nitric oxide (NO) by Griessassay (Promega); PGE2 by ELISA (Cayman Chemical); MMP-2, -3, -9, and -13by Luminex multiplex assay (R&D System); and IL-2, IL-4, IL-6, IL-7,IL-8, IL-10, IL-15, IL-18, GM-CSF, IP-10, IFNγ, KC, MCP-1, and TNFα byLuminex multiplex assay (Millipore).Data Analysis: Data were compared by ANOVA and the Tukey posthoc testusing SigmaStat.ResultsUndetected Analytes: The concentration of MMP-9, IL-2, IL-4, IL-7,IL-10, IL-15, IL-18, GM-CSF, IP-10, IFNγ, and TNFα were all below thedetection level of the assay in all samples analyzed for this study,indicating little production of these proteins during culture of OCAs.4° C. Culture vs. 37° C. Culture: After day 7, the 4° C. culture groupsreleased significantly (p<0.05) less KC, MCP-1, IL-8, MMP-2, MMP-3, andMMP-13. After day 7, production of all of these proteins decreasedsignificantly (p<0.05) in the 4° C. culture groups at all time pointstested.

The concentration of NO released to the media in the 4° C. group wassignificantly (p<0.001) lower than the M-1 and M-2 37° C. culture groupsat days 7 and 28, but not day 56. The M-3 37° C. culture group did notrelease detectable levels of NO at any time point tested, and thereforerelease significantly lower NO to the media compared to the 4° C. groupsat all time points. The concentration of PGE2 released to the media inthe 4° C. group was significantly lower than the M-1 and M-2 37° C.culture groups at all time points tested. The M-3 37° C. culture groupreleased significantly lower PGE2 to the media compared to the 4° C.culture groups at all time points.

M-1 vs. M-2 at 4° C. Culture: The M-2 4° C. culture group releasedsignificantly (p=0.008) higher NO on day 7, but not days 28 or 56,compared to the M-1 4° C. culture group. The M-1 4° C. group releasedsignificantly higher PGE2 on days 28 (p<0.001) and 56 (p=0.046), but notday 7, compared to the M-2 4° C. group. There was not a significantdifference between the M-1 and M-2 4° C. culture groups for MMP-2,MMP-3, MMP-13, KC, MCP-1, and IL-8 at any time point tested.M-1 vs. M-2 vs. M-3 at 37° C. Culture: The M-3 37° C. culture groupreleased significantly (p<0.05) lower NO and PGE2 at all time pointstested compared to the M-1 and M-2 37° C. culture groups. The M-2 37° C.group released significantly higher NO (p=0.042) and PGE2 (p=0.046) onday 28, but not (p>0.05) days 7 and 56. At days 7 and 28, but not day56, the M-2 37° C. culture group released significantly (p<0.05) lowerMMP-2 compared to the M-1 and M-3 37° C. culture groups. At day 7, butnot days 28 and 56, the M-1 37° C. group released significantly higherMMP-3 to the media compared to the M-2 and M-3 37° C. culture groups.There was not a significant difference in the media concentration ofMMP-13 between any of the 37° C. culture groups at the time pointstested. The media concentration of KC decreased significantly over timein culture for all 37° C. groups, but there was not a significantdifference between the 37° C. culture groups at any of the time pointstested. The media concentration of IL-6 was significantly (p<0.05) lowerin the M-2 37° C. group compared to the M-1 and M-3 37° C. groups on day7, but after day 7 the media concentration of IL-6 was below the levelof detection for almost all samples. On day 7, but not days 28 and 56,the media concentration of IL-8 was significantly (p<0.05) lower in theM-2 37° C. group compared to the M-1 and M-3 37° C. groups. Further, themedia concentration of IL-8 decreased significantly (p<0.05) over timefor all 37° C. culture groups at the time points tested. At all timepoints tested, the media concentration of MCP-1 was significantly(p<0.05) higher in the M-1 37° C. group compared to the M-2 and M-3 37°C. groups. However, the media concentration of MCP-1 decreasedsignificantly (p<0.05) over time for all 37° C. culture groups at thetime points tested.Discussion

The media concentrations of the proteins analyzed in this study werevery low for tissues cultured at 4° C. after the first week of culture.This indicates that the tissue becomes quiescent under thesenon-physiologic culture conditions. Conversely, the OCAs cultured at 37°C. maintained a relatively high level of protein production indicatingthat the chondrocytes remain metabolically active during preservation.

Of the proteins analyzed, MMP-2, MMP-3, KC, MCP-1, and IL-8 wereproduced most consistently. The stable release of NO and PGE2 to themedia throughout the preservation period by tissues stored at 4° C. wasa surprising finding. Without being bound by theory, it is possible thatthe release of these two inflammatory indicators results from theprogressive cell death within the tissue and requires very littlemetabolic activity by the tissue to be produced. The NO and PGE2 dataindicate that there is a continued and stable production of theseinflammatory mediators during the preservation of the OCAs at 4 and 37°C. in M1 and M2. Importantly, the M-3 media significantly reduced themedia levels of these two inflammatory mediators, indicating that M-3may protect the tissues during culture by decreasing inflammation andpotentially improving the health of the OCA.

A potential contributing factor to failure of OCA procedures clinicallyrelates to the viability of the tissue at the time of implantation.Therefore, a biomarker assay that can differentiate between tissues withlow and high viability by testing the preservation media prior toimplantation would be of great value to tissue banks and the surgeonsusing them clinically. These data suggest that proteins evaluated inthis study are potential markers for assessment of functional viabilityof OCAs. Taken together with previous work assessing cell viability andmatrix composition of preserved OCAs, preservation of osteochondraltissues in Media 3 and 37° C. is likely to allow for preserving higherquality grafts for a longer time period than currently used protocols

Example 2

Osteochondral Allograft Preservation in a Serum-Free Chemically-DefinedMedia

Osteochondral allografts (OCAs) are currently preserved at 4° C. andused within 28 days of donor harvest. The window of opportunity forimplantation is limited to 14 days due to a two week disease testingprotocol, severely limiting availability to potential recipients. Thisstudy was performed to assess the effects of storage up to 56 days in aserum-free chemically defined media at 37° C. OCAs from adult caninecadavers were aseptically harvested within four hours of euthanasia.Medial and lateral femoral condyles were stored in Media 1 or 2 at 4° C.or 37° C. for up to 56 days. Chondrocyte viability, proteoglycan (GAG)and collagen (HP) content, biomechanical properties, and collagen II andaggrecan content were assessed at Days 28 and 56. Five femoral condyleswere stored overnight and assessed the next day to serve as controls.Storage in Media 1 at 37° C. maintained chondrocyte viability atsignificantly higher levels than in any other media-temperaturecombination examined and at levels not significantly different fromcontrols.

OCAs stored in either media at 4° C. showed a significant decrease inchondrocyte viability throughout storage. GAG and HP content weremaintained through 56 days of storage in OCAs in Media 1 at 37° C. Therewere no significant differences in elastic or dynamic moduli amonggroups at Day 56. Qualitative immunohistochemistry demonstrated thepresence of collagen II and aggrecan throughout all layers of cartilageduring storage. OCA viability, matrix content and composition, andbiomechanical properties were maintained at “fresh” levels through 56days of storage in media 1 at 37° C. OCAs stored at 4° C. were unable tomaintain viability or matrix integrity through 28 days of storage.

Storage Protocol: OCAs within 4 hours of death from medial and lateralfemoral condyles of adult canine cadavers euthanized for reasonsunrelated to this study. Allografts were stored overnight in media at37° C., 95% humidity, and 5% CO2. Day 0 Control OCAs (n=5) wereaseptically harvested from one femoral condyle of 5 adult caninecadavers euthanized for reasons unrelated to this study. These OCAs werestored overnight in serum-free media and evaluated the following day.

The volume of each OCA (n=40) was determined and storage media volumesused were 25-30 times OCA volume. The OCAs were stored in Media 1 (DMEM,1X ITS (insulin, transferrin, and selenous acid), non-essential aminoacids (1 mM), sodium pyruvate (10 mM), and L-ascorbic acid (50 μg/ml))or Media 2 (DMEM, 1X ITS (insulin, transferrin, and selenous acid),non-essential amino acids (1 mM), sodium pyruvate (10 mM), L-ascorbicacid (50 μg/ml), dexamethasone (10 μM), TGF-β3 (2.5 ng/ml), and sodiumborate (250 μg/ml)).

Once the OCAs were aseptically processed they were preserved in eitherMedia 1 or 2 at 4° C. or 37° C. for 28 or 56 days. Media 1 was designedto provide basic nutrition to the tissue and Media 2 was designed to beanti-inflammatory and chondrogenic. Each stored specimen had its owncontralateral control on the opposite leg. The media were changed every7 days and media samples were saved for subsequent analyses. At eachtime point full-thickness cartilage was evaluated for chondrocyteviability, biochemical composition, and biomechanical properties.

Tissue Viability Analysis: Full-thickness cartilage from each storagegroup was used to determine chondrocyte viability. Quantitative analysisof chondrocyte viability was determined by manually counting live anddead cells from images for the entire sample taken at 10× magnificationusing an Olympus F view II camera and Micro Suite Basic Editionsoftware. CellTracker™ Green CMFDA (5-chloromethylfluorescein diacetate,Invitrogen, Carlsbad, Calif.) was used to visualize live cells andethidium homodimer-1 (EthD-1, Invitrogen, Carlsbad, Calif.) to visualizedead cells. Percent live cells were determined by taking the totalnumber of live cells divided by the total amount of cells in the sample.GAG Content: After PBS wash, cartilage plugs were blotted with a paperwipe and weighed on balance to obtain the wet weight. Dry weight wasdetermined after lyophilization for 24 hours. Cartilage tissue was thethen digested in 50 μL papain solution for 3 hours at 60° C.Sulfated-GAG (s-GAG) concentration within the cartilage matrix wasdetermined using aliquots of digest solution using the 1,9dimethylmethylene blue (DMMB) dye-binding assay. S-GAG content wasdetermined from the ratio of s-GAG to total tissue dry weight andreported at μg GAG/mg dry weight.HP Content: The hydroxyproline (HP) content was determined using acolorimetric assay modified to a 96-well format. HP content was used asa measure of total collagen content. A 50-μL aliquot of the digestsolution was mixed with 50 μL 4N NaOH and the mixture was autoclaved for20 minutes at 121° C. to hydrolyze the sample. The sample was then mixedwith the chloramine T reagent and incubated at 25° C. for 25 minutes,followed by mixing with Ehrlich aldehyde reagent. The chlorophore wasdeveloped at 65° C. for 20 minutes. The absorbance was then read at 550nm using a Synergy HT (Bio-TEK, Highland Park, Vt.) and the samples werecompared with an HP standard to determine the HP concentration of thesample. Results were standardized to tissue dry weight and reported asμg HP/mg dry weight.Biomechanical Analysis: At each end point, 4-mm plugs were removed fromthe articular cartilage and immediately put in a −80° C. freezer untilbiomechanical testing could be done. The dynamic modulus of cartilagespecimens were determined by unconfined compression with loading to 10%strain at a rate of 0.05% per second, after an initial 0.02-N tare load(elastic modulus, or Eγ). Dynamic modulus (G*) was measured bysuperimposing 2% peak-to-peak sinusoidal strain at 0.1 Hz. Values werereported as megapascals (MPa).Immunohistochemical Analysis: For immunohistochemical evaluation, 2-mmsagittal sections of OCAs were cut and fixed in 10% formalin. Afterfixation was complete, samples were decalcified in 10% disodiumethylenediaminetetraacetic (EDTA) acid. After decalcification andsubsequent routine histologic processing, each specimen was embedded inparaffin, and sectioned 5 μm through the sagittal plane. Forimmunohistochemical analysis, unstained sections were deparaffinized inxylene and rehydrated in graded ethanol solutions. The samples werepermeabilized with a 0.1% trypsin solution at 36° C. for 60 minutes andthen blocked with a 10% bovine serum albumin at 40° C. Slides wereincubated overnight at 4° C. in predetermined dilutions of the primaryantibodies: collagen type II (rabbit polyclonal antibody, Abcam,Cambridge, UK) and proteoglycan (mouse anti-human antibody, MilliporeCorp., Billerica, Mass.).

The next day, slides were rinsed in Tris-buffered saline before beingincubated with the secondary antibody. Collagen type II was labeled withgoat anti-rabbit fluorescein isothiocyanate (FITC, Millipore Corp.,Billerica, Mass.) and proteoglycan was labeled with goat anti-mouserhodamine (Millipore Corp., Billerica, Mass.). Samples were coverslippedand reviewed using fluorescent light microscopy. Negative controls wereused as comparison in which the primary (but not secondary antibody) wasomitted from the slides to see if any stain was due to fluorescenceaside from the target region. Immunohistochemical images weresubjectively assessed.

Statistical Analyses: Statistical analyses were done using theSigmaStat® computer software program (San Rafael, Calif.). Data werepooled for each endpoint, Day 28 and Day 56, and comparisons were madeamong the four storage media and Day 0 controls. A one way ANOVA usingTukey post-hoc comparisons was used for statistical analysis withsignificance set at p<0.05.Results: Chondrocyte viability of femoral condyle OCAs stored in Media 1at 37° C. was significantly higher than Media 1 and 2 at 4° C. (p=0.016,p=0.01) at Day 28. At Day 56, Media 1 at 37° C. had significantly highercell viability than Media 1 at 4° C. (p=0.008) and Media 2 at 4° C. and37° C. (p=0.015, p=0.023). When comparing stored OCAs to Day 0 controls,controls had significantly higher viability than OCAs in Media 1 and 2at 4° C. (p=0.007, p=0.01) at Day 28. OCAs stored in Media 1 at 37° C.were the only group able to maintain viability at levels notsignificantly different that controls through Day 56. Chondrocyteviability in control OCAs was significantly higher than OCAs in Media 1at 4° C. (p=0.032) and Media 2 at 4° C. (p<0.001) and 37° C. (p=0.002)at Day 56.

Analysis of tissue GAG content of femoral condyle OCAs showed nosignificant differences among storage groups at Day 28. At Day 56, OCAsstored in Media 2 at 37° C. had significantly less tissue GAG contentthan Media 1 at 4° C. (p=0.027) and 37° C. (p=0.033). At Day 28, therewere no significant differences in tissue GAG compared to controls.However, at Day 56, controls had significantly more tissue GAG contentthan OCAs stored in Media 2 at 37° C. (p=0.003).

There were no significant differences among femoral condyle OCA storagegroups with respect to HP content at Days 28 or 56. Also, there were nosignificant differences at any time point compared to controls.Biomechanical analyses of femoral condyle OCAs showed elastic modulus ofcontrols to be significantly higher than OCAs in Media 1 at 37° C.(p=0.017) and Media 2 at 4° C. (p=0.016) at Day 28. Dynamic modulus wassignificantly higher in controls than OCAs in Media 1 at 4° C. (p=0.032)and 37° C. (p=0.022) as well as Media 2 at 4° C. (p=0.041) at Day 28.There were no significant differences noted for Day 56 analyses.

Example 3

Assessment of Potential Biomarkers for Evaluating Viability ofOsteochondral Allograft Tissue During Preservation

Osteochondral allografts (OCA) allow transplantation of viable,functional tissue for treatment of cartilage defects without the needfor immunosuppression. OCAs are reported to be successful in >75% ofcases when used for treatment of focal femoral condyle lesions. Thepresent study was designed to evaluate the ability of biomarkers todifferentiate OCAs with low viability during culture using varioustissue preservation protocols.

Tissue Harvest and Culture: Medial and lateral femoral condyles (FC)from both knees of 10 adult canine cadavers were aseptically harvestedwithin 4 hours of euthanasia performed for reasons unrelated to thisstudy. The volume of each FC was determined and the FCs (OCAs, n=40)were processed under aseptic conditions and preserved in Media 1 (M-1)or Media 2 (M-2) at 4° C. or 37° C. for 28 or 56 days. The volume ofmedia used for preservation was determined by multiplying theapproximate volume of the tissue by 25-30. The media were changed every7 days, and collected for analysis of biomarker production. In a secondstudy, the FCs were aseptically harvested from one knee of 4 adultcanine cadavers euthanatized for reason unrelated to this study.

One FC per animal was processed under aseptic conditions and preservedin Media 3 (M-3) (DMEM, 1× ITS (insulin, transferrin, and selenousacid), L-glutamine (20 mM), non-essential amino acids (1 mM), sodiumpyruvate (10 mM), L-ascorbic acid (50 μg/ml), penicillin, streptomycin,amphotericin B, and sodium borate (250 μg/ml)) at 37° C. for 56 days asdescribed above. At each time point, full-thickness cartilage wasevaluated for tissue viability.

Tissue Viability Analysis: Cartilage tissue was analyzed for cellviability using a fluorescent live/dead assay (Invitrogen) andfluorescent microscopy. Images were taken at 10× magnification using anOlympus F-View II camera and MicroSuite Basic Edition software. For theM-1 and M-2 samples, two tissue sections were used for evaluation oftissue viability. For the M-3 samples at least three tissue sectionswere taken for evaluation of tissue viability. Green-staining live cellswere manually counted and the area of the tissue analyzed was determinedusing MicroSuite Basic Edition. Because % cell viability does not takeinto account total loss of cells, the area of the tissue sectionanalyzed was measured, and the ratio of live cells (LC)/area (mm2) wasdetermined.Media Analysis: Media were analyzed for MMP-2, -3, and -13 (R&D System)and IL-8, KC, and MCP-1 (Millipore) using two Luminex multiplex assay.Data Analysis: Data were compared by Pearson product-moment correlationusing SigmaStat.Tissue Viability (Table 1): The mean tissue viability represented theviability of each group well, but each group had one outlier. Further,the viabilities of M-2-37 and M-3-37 were significantly higher than allother groups. Because the response of the OCAs to each preservationprotocol was unique, the media protein data were analyzed to determineif the outliers could be identified in each group.All 4° C. Culture Groups: After day 14, the only analytes tested thatwere consistently detected were MMP-3 and KC, and the concentrations ofthese proteins were significantly lower than the day 7 values at alltime points. Further, a difference in the media concentration could notbe determined between the OCAs with the lowest tissue viability (0.23LC/mm2 M-1, 0.093 LC/MM2 M-2) and the highest tissue viability (1.14LC/MM2 M-1, 0.747 LC/MM2 M-2).M-1 37° C. Culture Groups: The variability in the tissue viability ofthe M-1 group was relatively low, and the viability of the tissues wasrelatively high. Therefore, there was not a distinct difference in thebiomarker values of the samples with low viability (˜0.7 LC/mm2) andhigh viability (≥1.0 LC/mm2). Interestingly, there was a negative weakto moderate correlation between cell viability and all the biomarkersanalyzed in this study. M-2 37° C. Culture Groups: The tissue viabilityof this group was significantly lower than the other 37° C. groups.After day 7 the concentration of KC and IL-8 had moderate-strongpositive correlations (0.569-0.995) with tissue viability depending onthe day analyzed. MCP-1 had weak-moderate (0.339-0.613) positivecorrelations with tissue viability throughout the culture period. MMP-2,MMP-3, and MMP-13 all had a moderate-strong (0.651-0.927) positivecorrelations on days 7 and 28, and a weak-moderate (0.337-0.6) positivecorrelations on day 56. The two samples with the lowest tissue viability(<0.1 LC/mm2) had little to no detectable KC, IL-8, MCP-1, MMP-2, MMP-3,and MMP-13 after day 7.M-3 37° C. Culture Groups: The M-3 group had the largest disparitybetween the samples with the highest (>1.0 LC/mm2) viability (n=3) andlowest (0.00 LC/mm2) viability (n=1). After day 14, little to no MCP-1,IL-8, and KC detectable in the media of the low viability sample. Earlyin culture, KC and MCP-1 had strong (0.815-0.972) positive correlationsto tissue viability, and at later time points in culture each hadmoderate (0.5-0.78) positive correlations to tissue viability. At alltime points, IL-8 had moderate (0.566-0.751) positive correlations tocell viability. MMP-2 had strong (0.811-0.907) positive correlationsthrough day 21; MMP-3 had strong (0.889-0.968) positive correlationsafter day 7; and MMP-13 had weak (0.3-0.461) positive correlations totissue viability at all time points. The sample with the lowest tissueviability (0.00 LC/mm2) had little to no detectable KC, IL-8, and MCP-1after day 7, but MMP-2, MMP-3, and MMP-13 could be detected at all timepoints.

These data indicate that proteins in the preservation media have thepotential to act as biomarkers for distinguishing OCAs that have verylow cell viability and therefore are not considered suitable forclinical use. If implemented, tissue banks could readily and repeatedlyassess the usefulness of the tissue during the preservation periodwithout the need for sectioning the grafts. This would essentially allowtissue banks to cull samples as soon as they are no longer acceptablefor clinical use, saving time and expense. It would also allow surgeonsto have more confidence in the quality of the grafts that they areimplanting into patients. KC, MCP-1, and MMP-3 are the strongestcandidate biomarkers to identify OCAs with low tissue viability duringculture.

TABLE 1 Tissue viability for each tissue preseravtion protocol TissueViability Storage Temp Days In (LC/mm2) Media ( C.) Storage Mean RangeM-1 4 28 0.57 0.245-1.088 M-1 4 56 0.41 0.112-1.143 M-1 37 28 1.050.819-1.24  M-1 37 56 1.03 0.736-1.32  M-2 4 28 0.5 0.033-0.892 M-2 4 560.37 0.093-0.747 M-2 37 28 0.6 0.110-0.882 M-2 37 56 0.36 0.009-0.628M-3 37 56 1.32 0.00-1.44

Example 4

Optimization of Osteochondral Allograft Preservation to Extend theUsable Life Span of Harvested Tissue

The present study was designed to evaluate the effectiveness ofculturing OCAs at 37° C. using different media compositions forextending the pre-implantation life span of harvested tissue based ontissue viability and matrix composition.

Methods

Tissue Harvest and culture: Medial and lateral femoral condyles (FC)from both knees of 10 adult canine cadavers were aseptically harvestedwithin 4 hours of euthanasia performed for reasons unrelated to thisstudy. The volume of each FC was determined and the FCs (OCAs, n=40)were processed under aseptic conditions and preserved in Media 1 (M-1)or Media 2 (M-2) at 4° C. or 37° C. for 28 or 56 days. The volume ofmedia used for preservation was determined by multiplying theapproximate volume of the tissue by 25-30. The media were changed every7 days, and saved for subsequent analyses. In a second study, FCs wereaseptically harvested from one knee of 5 adult canine cadaverseuthanatized for reason unrelated to this study. One FC per animal wasused as a freshly harvested day 0 control (n=5), and the other wasprocessed under aseptic conditions and preserved in Media 3 (M-3) (DMEM,1× ITS (insulin, transferrin, and selenous acid), L-glutamine (20 mM),non-essential amino acids (1 mM), sodium pyruvate (10 mM), L-ascorbicacid (50 μg/ml), penicillin, streptomycin, amphotericin B, and sodiumborate (250 μg/ml)) at 37° C. for 56 days as described above. At eachtime point, full-thickness cartilage was evaluated for tissue viability,proteoglycan (GAG) content, and collagen (HP) content.Viability Analysis: Cartilage tissue was analyzed for cell viabilityusing a fluorescent live/dead assay (Invitrogen) and fluorescentmicroscopy. For the M-1, M-2, and Day 0 control tissues full thicknesscartilage was excised from the bone; two 4 mm cartilage plugs werecreated from the tissue using a dermal punch; a ˜0.5 mm thick slice wastaken from the middle of the plug, and the slice was stained for 30minutes at 37° C. For the M-3 tissues a diamond saw was used to make a0.5 mm section from the center of the FC and this section was thenstained for 30 minutes at 37° C. Images were taken at 10× magnificationusing an Olympus F view II camera and MicroSuite Basic Edition software.For the M-1, M-2, and Day 0 samples one image from each slice (n=2images) was used for evaluation of tissue viability. For the M-3samples, at least 3 images from different areas of the slice were usedfor evaluation of tissue viability. Greenstaining live cells weremanually counted and the area of the tissue analyzed was determinedusing MicroSuite Basic Edition. Because % cell viability does not takeinto account total loss of cells, the area of the tissue sectionanalyzed was measured, and the ratio of live cells (LC)/area (mm2) wasdetermined.Biochemical Analyses: Tissue GAG content was determined using thedimethylmethylene blue assay. Tissue HP content was determined using thehydroxyproline assay. Tissue GAG and HP content was standardized totissue dry weight.Data Analysis: Data were compared by ANOVA and the Tukey post-hoc testusing SigmaStat.ResultsTissue culture: One sample in the M-2-37-56 group and M-3-37-56 groupwas lost to processing problems. Therefore, these groups only had 4samples for analysis.Tissue viability (FIG. 10 ): The mean tissue viability of the day 0controls was 1.13 LC/mm2 (1.03-1.25 LC/mm2). The tissue viability of theM-1-37 group was not significantly different than day 0 group at day 28or 56. There was not a significant difference between the M-3-37-56group and the day 0 control for tissue viability. The M-1-4, M-2-4, andM-2-37 groups all had significantly lower tissue viability compared tothe day 0 control (p<0.005-0.008), the M-1-37 group (p<0.016-0.025), andM-3-37 group (p<0.004-0.006) at all time points. There was not asignificant difference between the M-1-37 and M-3-37 groups.Tissue Matrix Composition: On day 56 the M-2-37 group had significantly(p<0.003-0.027) lower tissue GAG content compared to the day 0, both M-1groups, and the M-3-37 group (FIG. 11 ). Further, the M-2-4 group hadsignificantly (p<0.01) lower tissue GAG content compared to theM-3-37-56 group. There were no other significant differences for tissueGAG content. There was not a significant difference in the collagencontent of the tissues between any groups at any time point based on HPanalysis.

Example 5

Analysis of Osteochondral Allograft Metabolism Using VariousPreservation Protocols at 25° C.

Osteochondral allografts (OCA) allow transplantation of viable,functional tissue for treatment of cartilage defects without the needfor immunosuppression. Currently, tissue banks store OCAs at 4° C. andrecommend implantation within 28 days of harvest. The present study wasdesigned to evaluate the effects of various tissue preservationprotocols on the metabolism of OCAs based on the release of degradativeenzymes, cytokines, and chemokines to the media at 25° C. previouslyshown to be released during 37° C. storage.

Methods

Tissue Harvest and Culture: During the course of two studies, medial andlateral femoral condyles (FC) from both knees of 14 adult caninecadavers were aseptically harvested within 4 hours of euthanasiaperformed for reasons unrelated to this study. The FCs were separatedinto one of 5 test groups based on different media composition (M-1(DMEM, 1× ITS (insulin, transferrin, and selenous acid), L-glutamine (20mM), non-essential amino acids (1 mM), sodium pyruvate (10 mM),L-ascorbic acid (50 μg/ml), penicillin, streptomycin, and amphotericinB), M-2 (DMEM, 1× ITS (insulin, transferrin, and selenous acid),L-glutamine (20 mM), non-essential amino acids (1 mM), sodium pyruvate(10 mM), L-ascorbic acid (50 μg/ml), penicillin, streptomycin,amphotericin B, and sodium borate (250 μg/ml)), M-3 (DMEM, 1×ITS(insulin, transferrin, and selenous acid), L-glutamine (20 mM),non-essential amino acids (1 mM), sodium pyruvate (10 mM), L-ascorbicacid (50 μg/ml), penicillin, streptomycin, amphotericin B, anddexamethasone (0.01 μM))) and container condition (C-1, C-2, C-3) suchthat each FC from a single animal was placed in a distinct group. Thefollowing media and container condition groupings were assessed for thisstudy M-1/C-1, M-1/C-2, M-1/C-3, M-2/C-1, and M-3/C-3, resulting in the5 different OCA storage groups. Tissues were stored at 25° C. withoutCO2 supplementation in 60 mls of media for at least 63 days and up to 75days. The media were changed every 7 days and saved for biomarkeranalyses.Media Analysis: Media were analyzed for VEGF, matrix metalloproteinase(MMP)-2, -3, -9, and -13 by Luminex multiplex assay (R&D System); andIL-6, IL-8, KC, and MCP-1 by Luminex multiplex assay (Millipore).Data Analysis: Data from days 7, 28, and 56 of storage were compared byANOVA and the Tukey post-hoc test using SigmaStat.ResultsMMP-2: The release of MMP-2 to the media increased in all groups afterday 7, and remained stable from day 14 to the end of storage in theM-1/C-2 and M-1/C-3 groups of study 1 and the M-1/C-1, M-1/C-3, andM-3/C-3 of study 2. The M-1/C-1 and M-2/C-1 groups in study 1 haddecreasing levels of MMP-2 released to the media over time in cultureafter day 21, and on days 28 and 56 the M-1/C-3 had significantly highermedia MMP-2 levels compared to the M-1/C-1, M-1/C-2, and M-2/C-1 groups.In study 2 the M-3/C-3 group had significantly lower MMP-2 compared tothe M-1/C-3 group on days 28 and 56, and the M-1/C-1 group on day 28.MMP-3: After day 7 all groups in study 1 and the M-1/C-1 group in study2 released decreasing levels of MMP-3 to the media. However, the levelof MMP-3 in the M-1/C-3 group of study 1 remained stable after day 14and throughout culture for the M-1/C-3 and M-3/C-2 group in study 2. Onday 28 of study 1, the M-2/C-1 group had significantly lower media MMP-3levels compared to the M-1/C-1 and M-1/C-3 group, and on day 56 of study1 the M-1/C-3 group had significantly higher media MMP-3 levels comparedto all other groups. In study 2 the level of MMP-3 was not significantlydifferent between any groups at the time points analyzed.MMP-9: MMP-9 was not detected at any time point tested in both study 1and study 2.MMP-13: In study 1 the level of MMP-13 in the media increased quicklyafter day 7 in the M-1/C-1 and M-1/C-2 groups, and more slowly in theM-1/C-3 and M-2/C-1 groups. On day 28 the M-1/C-3 group hadsignificantly lower media MMP-13 compared to the M-1/C-1 and M-1/C-2groups. In study 2 the M-3/C-3 group had significantly lower mediaMMP-13 levels compared to the M-1/C-1 and M-1/C-3 groups on day 7 and28, and the M-1/C-1 group on day 56.KC: In study 1 the level of KC in the media was stable in the M-1/C-3,but decreased significantly in all other groups over time in storage. Instudy 2 the level of KC decreased significantly after day 7 in allgroups over time. In study 1, the media level of KC in the M-2/C-1 groupwas significantly lower than the M-1/C-2 and M-1/C-3 groups on day 7,all groups on days 28 and 56. In study 2, the media level of KC wassignificantly lower than in the M-3/C-3 group compared to the M-1/C-3group on days 28 and 56.IL-6: In study 1 and study 2 the media level of IL-6 spiked at day 7 anddecreased significantly and rapidly in all samples on subsequent days.In study 1 the M-2/C-1 group had significantly lower media IL-6 on day 7compared to all other groups, and the M-1/C-3 group had significantlyhigher IL-6 on day 56 than all other groups. In study 2 the M-3/C-3group had significantly lower media IL-6 compared to the M-1/C-1 andM-1/C-3 group on day 28 and 56.IL-8: In study 1 the media level of IL-8 was relatively stable over timein all groups but the M-2/C-1 group, which had decreasing medial IL-8levels over time in storage. In study 2 the level of IL-8 decreased overtime in culture in all groups. In study 1 the M-2/C-1 group hadsignificantly lower media IL-8 levels compared to all groups at all timepoints analyzed. Further, the M-1/C-3 group had significantly highermedia IL-8 levels compared to all other groups on day 56. In study 2 theM-3/C-3 group had significantly lower media IL-8 levels compared to theM-1/C-3 group at all time points and the M-1/C-1 group on days 28 and56.MCP-1: In study 1 the media level of MCP-1 decreased after day 14 andstabilized in all groups but the M-2/C-1 group, which had low MCP-1media levels from day 7 through day 56 of culture. In study 2 the medialevel of MCP-1 decreased after day 28 in culture in all groups. In study1 the media concentration of MCP-1 in the M-2/C-3 group wassignificantly lower than all other groups on days 28 and 56. Further,the M-1/C-3 group had significantly higher media MCP-1 compared to theM-1/C-1 group on days 28 and 56. In study 2 the media concentration ofMCP-1 in the M-3/C-3 group was significantly lower than the M-1/C-3group on day 56 of storage.VEGF: In study 1 the media level of VEGF was stable over time in theM-1/C-3 group, but decreased over time in all other groups. In study 2the level of VEGF was stable in all groups over time in culture. Instudy 1 the M-2/C-1 group had significantly lower media VEGFconcentrations compared to all groups on day 7 and the M-1/C-2 andM-1/C-3 groups on day 56. In study 2 the M-3/C-3 group had significantlylower media VEGF concentrations compared to the M-1/C-3 group at alltime points and the M-1/C-1 group on days 7 and 28.Discussion

These data indicate that OCA tissues are metabolically active during 25°C. storage, and that the same proteins detected in previous studies at37° C. storage are also detected at 25° C. storage. Further, the patternof production of these biomarkers at 25° C. is similar to that observedat 37° C.

Example 6

Optimization of Long-Term Osteochondral Allograft Storage at 25° C.

Osteoarthritis (OA) affects ˜90% of people older than 65, and associatedcosts top $100 billion annually in the U. S. One treatment available forfocal lesions is osteochondral allografts (OCA) transplantation. OCAsare reported to be successful in >75% of cases when used for treatmentof focal femoral condyle lesions. Currently, tissue banks store OCAs at4° C., and implantation is recommended within 28 days after harvest dueto significant loss in tissue viability by this time point. Becausemandatory disease screening protocols typically take 14 days tocomplete, the window for surgical implantation is narrow (˜14 days),which severely limits clinical use. Therefore, this study was designedto evaluate the effectiveness of culturing OCAs at 25° C. using novelmedia compositions and container conditions for extending thepre-implantation life span of harvested tissue based on tissue viabilityand matrix composition.

Methods:

Tissue harvest and culture: During the course of two studies, medial andlateral femoral condyles (FC) from both knees of 14 adult caninecadavers were aseptically harvested within 4 hours of euthanasiaperformed for reasons unrelated to this study. The FCs were either usedas day 0 controls (n=7) or separated into one of 5 test groups based ondifferent media composition (M-1 (DMEM, 1× ITS (insulin, transferrin,and selenous acid), L-glutamine (20 mM), non-essential amino acids (1mM), sodium pyruvate (10 mM), L-ascorbic acid (50 μg/ml), penicillin,streptomycin, and amphotericin B), M-2 (DMEM, 1× ITS (insulin,transferrin, and selenous acid), L-glutamine (20 mM), non-essentialamino acids (1 mM), sodium pyruvate (10 mM), L-ascorbic acid (50 μg/ml),penicillin, streptomycin, amphotericin B, and sodium borate (250μg/ml)), M-3 (DMEM, 1× ITS (insulin, transferrin, and selenous acid),L-glutamine (20 mM), non-essential amino acids (1 mM), sodium pyruvate(10 mM), L-ascorbic acid (50 μg/ml), penicillin, streptomycin,amphotericin B, and dexamethasone (0.01 μM))) and container condition(C-1, C-2, C-3) such that each FC from a single animal was placed indistinct group. The following media and container condition groupingswere assessed for this study M-1/C-1, M-1/C-2, M-1/C-3, M-2/C-1, andM-3/C-3, resulting in the 5 different OCA storage groups. Tissues werestored at 25° C. without CO2 supplementation in 60 mls of media for atleast 63 days and up to 75 days. The media were changed every 7 days andsaved for biomarker analyses. At the end of storage, osteochondral plugswere evaluated for tissue viability and matrix composition.Viability Analysis: Cartilage tissue was analyzed for cell viabilityusing a fluorescent live/dead assay (Invitrogen) and fluorescentmicroscopy. Osteochondral tissues were incubated in stain for 25 minutesat 25° C. Images were taken at either 4× (study 1) or 10× (study 2)magnification. Green-staining live cells were manually counted, and thearea of the tissue analyzed was determined. The viability of the tissueis expressed as the ratio of live cells (LC)/area (μm²). Because thefocal depth of 4× images was significantly different than the focaldepth of 10× images, the viability could not be compared between the 4×and 10× images, and analysis was only performed between samples thatwere taken at the same magnification.Matrix composition: Cartilage tissue was lyophilized and weighed,digested with papain, and analyzed for proteoglycan content using theDMMB assay and collagen content using a hydroxyproline assay. GAG andcollagen content was normalized to tissue dry weight.Data Analysis: Data were compared by ANOVA and the Tukey post-hoc testusing SigmaStat.RESULTS: Day 0 and day 63-75 tissue viability (Table 2): The mean tissueviability and range are listed for each group at day 63 for eachmagnification. For the samples analyzed at 4× magnification, day 0 andthe M-3/C-3 group had significantly higher tissue viability (LC/mm2)compared to the M-1/C-1 and M-2/C-1 groups at day 63, and the M-1/C-3group had significantly higher tissue viability compared to the M-2/C-1group at day 63. The M-3/C-3 group had the highest mean viability andthe lowest variability of all the storage groups tested. The sample sizewas smaller for the 10× magnification groups, and there was not asignificant difference between the groups as seen in the first set ofsamples analyzed at 4× magnification. However, in agreement with the 4×data, the M-3/C-3 group had the highest viability with the lowestvariability and was closest to day 0 viability values.Day 0 and day 63-75 cell distribution: The day 0 and M-3/C-3 groups hadgood cell numbers distributed through the thickness of the tissue. TheM-1/C-1 and M-1/C-2 groups typically had very low cell numbers in thesuperficial-middle zones of the tissue and higher cell numbers in thedeep-middle zones of the tissue. The M-2/C-1 group had very fewdetectable viable cells in any region of the tissue.Matrix composition (FIG. 12 ): The proteoglycan content of the M-3/C-3group was significantly lower than the day 0 and all other storagegroups. The GAG content of the tissues was not a significantly differentbetween any other groups in this study. The HP content of the first setof tissues stored could not analyzed for HP content, so there is no HPdata for the M-1/C-2 and M-2/C-1 groups tissues. Of the samples tested,there was not a significant difference between the groups tested.DISCUSSION: These data indicate that femoral condyle OCA tissue storedat 25° C. without CO2 supplementation can maintain day 0 tissueviability up to 75 days in storage. This is a significant improvementover current protocols at 4° C., which shows significant loss of tissueviability by day 28 of storage.

TABLE 2 Tissue viability for each tissue protocol 4x Tissue Viability10x Tissue Viability CONTAINER (LC/μm2) (LC/μm2) Media CONDITION MeanRange Mean Range M-1 C-1 0.916 0.038-3.24  0.623  0.0-1.38 M-1 C-2 2.1151.29-2.62 M-1 C-3 2.217  0.1-3.49 0.804 0.213-1.36  M-2 C-1 0.0423 0.0-0.117 M-3 C-3 3.195 2.99-3.31 1.137 0.97-1.29 Day 0 2.901  0.5-5.351.13 1.02-1.25

Example 7

Evaluation of Osteochondral Allograft Viability During Preservation at25° C.

Osteochondral allografts (OCA) allow transplantation of viable,functional tissue for treatment of cartilage defects without the needfor immunosuppression. OCAs are reported to be successful in >75% ofcases when used for treatment of focal femoral condyle lesions. Thisstudy was designed to evaluate the ability of biomarkers and the mediaadditive to differentiate OCAs with low viability during culture usingvarious tissue preservation protocols at 25° C.

Methods

Tissue Harvest and Culture: During the course of two studies, medial andlateral femoral condyles (FC) from both knees of 14 adult caninecadavers were aseptically harvested within 4 hours of euthanasiaperformed for reasons unrelated to this study. The FCs were separatedinto one of 5 test groups based on different media composition (M-1(DMEM, 1× ITS (insulin, transferrin, and selenous acid), L-glutamine (20mM), non-essential amino acids (1 mM), sodium pyruvate (10 mM),L-ascorbic acid (50 μg/ml), penicillin, streptomycin, and amphotericinB), M-2 (DMEM, 1× ITS (insulin, transferrin, and selenous acid),L-glutamine (20 mM), non-essential amino acids (1 mM), sodium pyruvate(10 mM), L-ascorbic acid (50 μg/ml), penicillin, streptomycin,amphotericin B, and sodium borate (250 μg/ml)), M-3 (DMEM, 1× ITS(insulin, transferrin, and selenous acid), L-glutamine (20 mM),non-essential amino acids (1 mM), sodium pyruvate (10 mM), L-ascorbicacid (50 μg/ml), penicillin, streptomycin, amphotericin B, anddexamethasone (0.01 μM))) and container condition (C-1, C-2, C-3) suchthat each FC from a single animal was placed in a distinct group. Thefollowing five media and container condition groupings were assessed forthis study: M-1/C-1, M-1/C-2, M-1/C-3, M-2/C-1, and M-3/C-3. Tissueswere stored at 25° C. without CO2 supplementation in 60 mls of media forat least 63 days and up to 75 days. The media were changed every 7 daysand saved for biomarker analyses. On the next to last day of storage, 6mls of the cell viability media additive as added to each sample andincubated for 24 hours. After 24 hours, a media sample was analyzed forlevel of fluorescence at a standard sensitivity. Increased fluorescencein the media is indicative of cell metabolism and viability.Media Analysis: Media were analyzed for VEGF, matrix metalloproteinase(MMP)-2, -3, -9, and -13 (R&D System); and IL-6, IL-8, KC, and MCP-1 byLuminex multiplex assay (Millipore).Tissue Viability Analysis: Cartilage tissue was analyzed for cellviability using a fluorescent live/dead assay (Invitrogen) andfluorescent microscopy. Images were taken at 4× magnification using anOlympus F-View II camera and MicroSuite Basic Edition software.Greenstaining live cells were manually counted, and the area of thetissue analyzed was determined using MicroSuite Basic Edition. The areaof the tissue section analyzed was measured, and the ratio of live cells(LC)/area (μm2) was determined.Data Analysis: Data from the last day of storage were compared byPearson product-moment correlation using SigmaStat. Since the M-3 mediawas designed to decrease tissue inflammation, the cytokines andchemokines analyzed in this study were significantly lower in this groupcompared to all others during the course of storage. Therefore, the M-3media cytokine data could not be analyzed with the other mediacompositions used in this study, but the MMP and media supplement datawere used for analysis.ResultsTissue Viability: The mean tissue viability represented the viability ofeach group well, but each group had one outlier except the M-2/C-1 groupand the M-3/C-3 group. Further, the viabilities of M-1/C-3 and M-3/C-3groups were significantly higher than all other groups.Correlation Analysis (FIG. 13 ): A significantly (p<0.001) moderate tostrong positive correlation to tissue viability was found for the mediaviability additive (r=0.724), IL-8 (r=0.598), VEGF (r=0.655), KC(r=0.738), MCP-1 (r=0.822), MMP-2 (r=0.699), and MMP-3 (r=0.682). Therewas not a significant correlation to tissue viability for IL-6 (r=0.385,p=0.0694) and MMP-13 (r=0.203, p<0.319).Discussion

These data indicate that similar to OCAs stored at 37C, theconcentration of proteins in the preservation media at 25° C. have thepotential to act as biomarkers for identifying OCAs that have very lowcell viability and therefore are not considered suitable for clinicaluse.

What is claimed is:
 1. A process for tendon tissue preservationcomprising storing the tendon tissue at room temperature in a containercomprising a serum-free culture medium comprising dexamethasone for fromabout 7 to about 70 days prior to implantation, wherein at least 70% ofthe cells of said tendon tissue remain viable after said storingcompared to the viability of the cells of the tendon tissue at day
 0. 2.The process of claim 1, comprising testing the tendon tissue forviability at least once prior to implantation in a patient.
 3. Theprocess of claim 2, wherein testing for viability comprises assayingmedium withdrawn from said container.
 4. The process of claim 2, whereintesting for viability comprises adding a resazurin solution to themedium and determining a fluorescence level, wherein increasedfluorescence indicates higher cell viability.
 5. The process of claim 1,comprising storing the tendon tissue for from 29 to about 70 days. 6.The process of claim 1 comprising changing said medium at least onceduring the storing, or changing the media about once every two weeksduring the storing.
 7. The process of claim 1, wherein at least about70% of cells of said tendon tissue preserved by said process remainviable after 45 days of storing.
 8. The process of claim 1, wherein themedia comprises Dulbecco's Modified Eagle Medium (DMEM), high or lowconcentrations of glucose, antibiotic compounds, antimycotic compounds,ascorbate 2-phosphate, L- proline, sodium pyruvate, Transforming growthfactor-β3 (TGF-β3), insulin, transferrin, and selenous acid.
 9. Theprocess of claim 1, wherein the tendon tissue comprises an allograft,the process comprising storing the tendon tissue in a tissuepreservation chamber comprising a base, lid, media inlet, and mediaoutlet; wherein the media inlet is coupled to at least a first filterfor maintaining a sterile environment inside the chamber; wherein thebase is configured to contain the tendon tissue and medium; the outletextending into the chamber to permit removal of medium; the media outletcomprising a one-way valve for exit of medium from the chamber; whereinthe base is capable of receiving the lid to form a barrier tocontaminants.
 10. The process of claim 9, comprising storing the tissuein the chamber for from about 29 days to about 60 days.
 11. The processof claim 1, wherein the tendon tissue comprises a section of spine,scapula, humerus, radius, ulna, pelvis, femur, tibia, patella, talus,phalanges or temporomandibular joint tissue.
 12. The process of claim 1,wherein the tendon tissue comprises an allograft, the process comprisinglavaging of the tendon tissue in isotonic solution prior to storing. 13.The process of claim 1, further comprising implanting the tendon tissuein a subject in need thereof following said storing.
 14. A method forpreserving tendon tissue at room temperature in a chamber comprisingserum-free culture medium comprising dexamethasone prior toimplantation, the method comprising: placing the tendon tissue in achamber base, the chamber base with said serum-free culture medium, thechamber base configured to maintain the tissue and said serum-freeculture medium; forming a tissue preservation chamber by covering thechamber base with a lid to form a barrier to contaminants, the chambercomprising at least one filter, a media inlet coupled to at least onefilter for maintaining a sterile environment inside the chamber, and amedia outlet, the media outlet including a media outlet conduit thatextends into the chamber to permit removal of medium; wherein the mediaoutlet comprises a one-way valve to prevent reentry of medium exitingthe chamber; and storing the tendon tissue at room temperature for fromabout 7 days to about 70 days prior to implantation, wherein at least70% of the cells of said tendon tissue remain viable after said storingcompared to the viability of the cells of the tendon tissue at day 0.15. The method of claim 14, further comprising storing the tissue in thechamber for from 29 days to about 70 days.
 16. The method of claim 15,further comprising simultaneously adding medium to the chamber byforcing through the media inlet and at least one filter and removingmedia from the chamber through the medium outlet.
 17. The method ofclaim 15, further comprising applying tamper evident tape to aninterface between the chamber base and the lid.